Patent pool

In 2000, first-line HIV treatments cost an average of $10,000 (7,500 euros) per person per year - something only wealthy patients could afford.

Today, people infected with HIV in developing nations can be treated for less than $70 per year – a decrease in price of more than 99 percent, according to United Nations figures.

The radical price drop is due largely to competition from generic companies that started producing antiretrovirals (ARVs) for HIV treatment.

Robust generic competition

Of the 34 million people currently infected with HIV, 95 percent live in developing nations.

There has been progress: The number of new infections and death rates related to AIDS has gone down to their lowest levels since the peak of the epidemic, according to the latest United Nations Programme on HIV/AIDS (UNAIDS) report published in November 2011.

Still, access to appropriate treatment remains a challenge, especially in developing countries. Fewer than half of the more than 15 million people now in need of HIV therapy receive it.

"Right now, we're in an absurd situation where the signposts all point in one direction to get a handle on HIV/AIDS, yet the funding crunch is pulling us the opposite way," Shelagh Woods from Médecins Sans Frontières said in a statement.

The organization points critically to the Global Fund to Fight Aids, Tuberculosis and Malaria being forced to skip a year of funding new proposals for the first time since it was created in 2002. "We have to act fast and reach as many people as possible to save lives and avoid slipping back, but countries can't do this alone," Woods said.

A program to pool patents could help speed up support. When the United Nations launched the Medicines Patent Pool in 2010, "the goal was to bring down prices of ARVs and improve inhibition on appropriate and affordable medicine so that the people who need it can access it," said Kaitlin Mara from the Medicines Patent Pool, which was set up by UNITAID.

The pool obtains licenses from medicines patent holders and makes them available to third parties in developing countries that can produce more affordable generic versions of the drugs. Companies are paid royalty fees by the pool.

First agreement signed

"One year after it sent out letters to companies on World AIDS Day 2010, the pool is already proving a success," Mara told Deutsche Welle.

In July 2011, the initiative completed its first agreement with Gilead Sciences, which logged almost $6 billion in AIDS-drugs sales in 2009. Negotiations with six other companies are underway.

Gilead Sciences is currently working on five products, which will all fall under the agreement. As soon as research and development is completed and the drugs have been approved by the relevant bodies, generic manufacturers in developing countries can start obtaining licenses for reproduction of the drugs.

The pool also helps stimulate innovation and production of drugs for niche markets, such as pediatric therapy. "The vast majority of children infected with HIV live in developing countries, but medicines adapted for children are not prioritized by the pharmaceutical companies because the market for these products is very limited in wealthy nations," Mara said.

Positive publicity after years of conflict

Drug manufacturers, harshly criticized for their high prices a decade ago, have been cutting prices lately. Some, like Pfizer, have also licensed AIDS drugs for free to nonprofit organizations.

Giving third parties in developing countries the license to manufacture the drugs generates positive publicity for the big pharmaceutical players, supporters argue.

Nonprofit organizations have largely welcomed the Medicines Patent Pool initiative, but most say it can only be a first step. The fact that manufacturing was confined to India was criticized by Diarmaid McDonald, coordinator of the Stop AIDS Campaign, on his organization's website.

"This deal is very welcome but it excludes countries with serious poverty and HIV epidemics like Brazil and China," he said.

"This deal is a floor, not a ceiling, and we now need to see all other companies reach agreements which exceed these terms."

Author: Nina Haase
Editor: Stuart Tiffen